The child has 3 health group. Children's health group - a comprehensive assessment on a medical examination and classification of distribution criteria

A health group is a cumulative assessment of a child's health and development, which takes into account risk factors that have influenced him in the past, that influence in the present and determine the projections for the future. The health group is established by the district pediatrician based on six main criteria. The criteria determine the likelihood of hereditary diseases, the physical and neuropsychic development of the child, the body's resistance, work internal organs and systems, the presence of chronic diseases or congenital malformations.

As a result of a medical examination, children are assigned to 5 groups for health reasons.

• Health group 1

Children are healthy according to all the main assessment criteria, as well as children with single morphological deviations that do not affect the child's health.

• Health group 2

Children are healthy, but prone to chronic diseases, as well as functional and some morphological abnormalities, with reduced resistance to acute chronic diseases.

• 2 health group has two subgroups of children:

A) - these are healthy children, but with a burdened heredity, or there is a severe pregnancy or complicated childbirth.

B) - these are children who are often ill, with some functional deviations and the risk of developing chronic diseases.

2 health group - these are children requiring attention from a doctor and parents. It is necessary to establish a certain level and intensity of physical activity for the child, because these are not sick children.

• Health group 3

This group includes children with chronic diseases or congenital pathology in a state of compensation, i.e. with infrequent exacerbations, without a pronounced deterioration in general well-being. Such children have a slightly reduced body resistance. Diseases in the presence of which a third health group is assigned are chronic bronchitis, chronic gastritis, pyelonephritis, obesity, anemia, adenoids, stuttering, chronic duodenitis, DVP and flat feet.

At the end of the term dispensary observation and long absence exacerbations of the disease, the child of the third health group is transferred to the second. Such a child is considered healthy with a note of the presence of a disease in the past. For example, children with anemia recover and have stable hemoglobin levels. Children with the third health group usually attend special group in gymnastics or physiotherapy exercises... For example, obese children are encouraged to walk, swim, and moderate jogging, and for children with flat feet, foot exercises and walking on a gymnastic stick.

• Health group 4

These are children with congenital malformations in the stage of subcompensation, with chronic diseases, with reduced functional capabilities, but without significant impairment of well-being.

• Health group 5

Children having severe chronic diseases decompensated or severe physical disabilities... This group includes disabled children.

The physical component of health determines the mental and social well-being of the child, his harmonious development, success in adult life... Developmental defects, the presence of chronic diseases, congenital anomalies require adjustment of physical activity and constant medical supervision... Comprehensive medical examinations make it possible to assess the state of the physiological systems of the body, the dynamics of pathology, in order to determine the health group in children for the organization of restorative classes and rehabilitation measures.

What is a child health group

In pediatric practice, the concept of "children's health group" - symbol, which is used by doctors to assess the general condition of the body. The conclusion is made on the basis of a comprehensive examination narrow specialists and a local pediatrician. The conclusion is issued at the moment, so the health group may change. It depends on the dynamics of the state.

It is necessary to assess and determine the health group in children of different age categories in order to provide timely medical assistance or organize the supervision of narrow specialists. Its definition is very important for children who attend educational institutions. When diagnosing chronic diseases, the presence of developmental anomalies, a special group is assigned, in which requirements are reduced and physical activity is reduced.

How to determine the health group of a child

Only qualified doctors determine the health groups of children and adolescents. Narrow specialists who are part of medical commission, draw conclusions after examination and additional research. All data are provided to the pediatrician, who, based on the conclusions of the commission, laboratory tests, criteria for a comprehensive assessment of health, and his own observations, gives a conclusion. The health group in children is determined taking into account data on the course of pregnancy and early development.

Referral for annual physical examination

In the parental environment, there is an opinion that annual medical examinations are a whim of doctors and a waste of time. Parents sometimes do not notice how and when a child's chronic illness began to develop. His whims, complaints of fatigue, feeling unwell write off on laziness or bad temper. Having a medical examination once a year is necessary and justified. Statistics indicate a small percentage of absolutely healthy children.

The state has legalized the obligatory passage of a medical examination in 1 year, when registering for a child preschool, before entering the 1st grade of school, annually at school age. Parents need to understand that they cannot formally refer to a medical examination. A comprehensive health assessment is carried out not in order to obtain a certificate of the possibility of attending a kindergarten or school, but for the timely detection of diseases and developmental disabilities.

At the annual examination, the doctor analyzes the anthropometric data, lab tests, dynamics of morbidity. The medical report indicates whether it is possible to visit children's institution, belonging to a group in physical education. It will help parents to adjust the daily routine, nutrition, mental and physical exercise... When pathological conditions are detected, dispensary registration is drawn up, observation by a narrow specialist.

Comprehensive assessment of the health status of children

Clinical examination involves examination by narrow specialists. The district pediatrician, on the basis of their findings and his own observations, makes a comprehensive assessment of the physiological state of the patient. The medical commission includes:

• surgeon (identifying possible violations posture);
• ophthalmologist (determination of visual acuity and its correction);
• ENT (identifying the structural features of the nasopharynx, a tendency to diseases of the throat, nose, ear);
• cardiologist (work control of cardio-vascular system);
• neuropathologist (identifying features nervous system);
• dentist (checking the condition of the teeth).

What to do if a child has a functional disorder or a chronic disease

The purpose of the annual preventive examination is to determine possible functional disorders and chronic diseases. When they are identified, a comprehensive assessment of the state of health is not done. Additional studies are being carried out, the diagnosis is being clarified. Only then does the pediatrician give a comprehensive assessment. This is the algorithm for the actions of the medical commission in the initial detection of pathologies.

Classification criteria

There are developed criteria for the health of children, their classification is diverse. In pediatric practice, 5 basic principles are popular, according to which the health group in children is determined:

1. Heredity. When examining a newborn, the doctor finds out the presence of hereditary diseases that are recorded in several generations of the family. In the presence of genetic abnormalities, laboratory tests will help determine the likelihood of such a disease. The genealogical criterion takes into account the peculiarities of the course of pregnancy, the birth itself, the development of the newborn in the first month.
2. Physical development. This is based on the basic anthropometric data: height, weight, head circumference, chest, limb length and others. There is a special table in which digital indicators of normal physical development are prescribed.
3. Development of organ systems. In parallel with the increase in body weight and growth, the formation of internal organs and their systems occurs. This process can be controlled using additional analyzes and hardware techniques (for example, ultrasound). Special attention doctors devote to the development of organs that provide the basic life processes - the heart, stomach, kidneys, lungs.
4. The degree of immune protection. A healthy body reliably resists factors environment less prone to infections. The reason weak immunity in frequently ill patients, it is necessary to find out without fail, by conducting additional examination and diagnostics.
5. The ratio of mental and physical health... The neuropathologist, psychologist and pediatrician jointly determine the passage of the body's nervous reactions, the level of development mental processes, physical health and correlate the data with special tables of standards.

Children's health groups and their characteristics

A comprehensive assessment of the state of health is carried out from 3 to 17 years old according to specially developed criteria. The health group in children is indicated by Roman numerals. Belonging to it is determined not so much by the established diagnosis as physical capabilities, therefore, patients with the same diseases can be in different groups.

Parents express concern when their children’s health group is not in line with normal values. The doctor's conclusion about its assignment is not a diagnosis. Medical gradation of this type provides a comprehensive assessment of physical development and the ability to correct it in the future, taking into account various factors that actively influence him.

I group of health

Absence of anatomical defects and functional pathologies. Patients are practically healthy and rarely get sick. The identified functional abnormalities in the body do not affect the overall physiological condition and do not require special medical correction. At the time of examination, they are practically healthy, have single deviations in nervously- mental development.

II group

Small deviations are recorded, immune defense... There are no chronic diseases, functional disorders are diagnosed. A general delay in physical development is expressed: excess or underweight, impaired vision, anemia, flat feet and other dysfunctions. Health group 2 in a child means that he often suffers from acute respiratory infections (more than 4 times a year). There is a great risk of developing pathological conditions, their transition to a chronic disease. Subgroup 2a unites patients with risk factors for the development of diseases:

• genetic (hereditary diseases);
• biological (severe pregnancy and difficult childbirth);
• social (smoking, alcoholism, work of parents on hazardous production, late pregnancy, sexually transmitted diseases, threat premature birth or miscarriage).

Subgroup 2b is characterized by the presence of morphological abnormalities and functional disorders. Newborn babies are characterized by diseases that they suffered in the first minutes, hours of life. After being discharged from maternity hospital pathologies persist, the risk group is indicated. The pediatrician draws up a follow-up plan, conducts systematic examinations and preventive actions, prescribes treatment if necessary. These babies are often sick. They need constant monitoring at home.

III group

Chronic diseases that are characterized by prolonged periods of remission. Rarely, exacerbations of the condition occur, which pass without complications of the underlying disease. Small patients have normal physical development, but anthropometric indicators(height, body weight) below normal. Health group 3 in a child is an indicator of mental retardation.

IV group

Several chronic diseases are present. One or several diseases are in the stage of subcompensation, there are severe defects, pathological conditions... This includes patients who are in remission with ongoing maintenance treatment. This includes patients with physical disabilities due to trauma and operations.

V group

Severe chronic illness, physical defects, dysfunction of vital internal organs. This includes the most severe patients, who often have deterioration and seizures, followed by complications. The underlying disease requires constant treatment measures... Children with disabilities are enrolled here.

Newborn health groups

In pediatrics, there is a special health assessment for newborns. Membership in a certain group is determined upon discharge from the maternity hospital. This is the basis for drawing up a plan for working with the baby. A set of measures is carried out by a local pediatrician. The criteria by which the health group of a newborn is determined are shown in the table:

What is the Apgar scale

Rapid universal assessment of the health status of a newborn is determined by the Apgar scale. This system was created in 1952, developed by the American anesthesiologist Virginia Apgar. Using the scale, the doctor quickly assesses the vital important signs baby. It includes 5 criteria, which are determined at 1 and 5 minutes of life. Each criterion is assessed by points, they are summed up, and the condition of the newborn is assessed by this figure.

There is a special table in which the assessment scale is painted (from 0 to 2 points) for each of the criteria:

• breath;
• heart rate;
• muscle tone;
• reflexes;
• skin color.

It is great if each criterion is assessed by a doctor at 2 points, but a newborn cannot get 10 points in the first minute of life (feet and hands are bluish). Grade 9 gets absolutely healthy baby, who can breathe on his own, his pulse is more than 100 beats per minute, arms and legs are bent at the joints. He screams loudly, sneezes, responds to manipulations with movements, his skin is healthy pink color... The norm is 7 points or more - the physiological state of the newborn is good, special care it does not need it.

Resuscitation measures are carried out for babies who received 4-6 points on the Apgar scale. Its condition is monitored every 5 minutes, at 10, 15, 20 minutes. Positive dynamics in the course of observation indicates the correctness of the medical measures being carried out. A score below 4 requires immediate medical actions to save the life of a newborn.

The coefficient 3-4 for the Apgar jackal implies average deviations from normal performance... With constant monitoring medical staff the condition of the newborn is classified as satisfactory. Indicators 0-2 are assessed as critical, urgent resuscitation actions are required, in the future additional examinations and observation by specialists.

Health groups in preschool educational institution classified by a pediatrician. The age category of children is 3-6 years old. Indeed, in mandatory, before visiting the preschool educational institution, all babies undergo a medical examination by a number of doctors. The conclusion about the state of health is issued by the pediatrician, having carefully studied the analyzes and records of other doctors.

This is necessary in order to determine the direction of the preschool educational institution, perhaps some crumbs need special conditions or constant observation medical worker... If there are such indicators, then children are sent to specialized kindergartens, where they are installed necessary care.

The classification of children into health groups is as follows:

1. The first is children who do not have any abnormalities or diseases. Development, both physiological and psychological nature complies with the standards that are defined for this age group... That is, their general state the body is in perfect order and they have no restrictions in visiting kindergarten.
2. The second is children who have revealed small deviations. For example, it could be chronic diseases not having relapses, frequent colds, allergic reactions. All these problems must be indicated in the medical records of children when visiting a preschool educational institution. They must be taken into account when carrying out any physical exercise or activities. If this is a problem gastrointestinal tract, then in kindergarten individual meals are prepared for the baby.
3. The third is children who have been diagnosed with chronic diseases with periods of exacerbation, but not very long. The state of health, both physical and psychological, must comply with the standards.
4. The fourth is children who have chronic form diseases having long periods exacerbation. Or a kid who has a limitation functionality, or physical disabilities. Such children must be assigned to specialized preschool educational institutions in accordance with the direction issued by the pediatrician. Spend here with them special classes preventive or curative in order to maintain their health. And also they are under the constant supervision of highly professional specialists.
5. Fifth - these are crumbs with very large physical disabilities, psychological or physiological deviations in development - these are children with disabilities.

• It is interesting:

What health group should you include your baby in?

As before, the condition of children can be determined based on 4 main criteria:

• whether the baby has functional disorders or diseases of a chronic nature. The severity of the disease itself and how strongly the pathology is developed is taken into account;
• functional state of the body, all its main organs and systems;
• how strongly the body can resist bad external influences;
• the level of development of children, how harmonious and age-appropriate it is.

The first and second groups are children who will attend the preschool educational institution on a general basis, without any possible limitations... Children with the third health group usually require special, individual, nutrition or exercise restrictions.